Individual
MR. TIMOTHY JOSEPH DOHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
801 BENTON RD, BOSSIER CITY, LA 71111-3743
(318) 742-3509
Mailing address
4057 WOODWAY DR, BENTON, LA 71006-9354
(318) 965-1844
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
13320
LA
183500000X
Pharmacist
36933
TX
Other
Enumeration date
08/26/2013
Last updated
08/26/2013
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